The purpose of the Pediatric Nephrology Training Program at the University of Washington (UW) is to educate a diverse group of young pediatricians to become physician-scientists and future academic leaders in Pediatric Nephrology. This will be accomplished by an intense year of clinical training, supported by institutional funds, followed by at least two years of comprehensive research training in one of three available research pathways: clinical, translational or basic science. Trainees who graduate from this program are board-eligible in Pediatric Nephrology and expected to assume faculty positions at academic institutions. Over the past 10 years all positions in this program have been filled and 100% of matriculated fellows have successfully completed the 3- year program;88% are pediatric nephrologists at academic institutions and 12% are at other Children's Hospitals (one soon to be university-affiliated). Most of the graduates have maintained an interest in research including 31% with K-type and 19% with R-type NIH grants. The program (years 21 - 25) is seeking continued funding to support four MD, DO or MD/PhD pediatrician trainees annually. The need for this training is clear based on continued manpower shortage projections and the need for new scientific discoveries to prevent, recognize/diagnose and treat kidney disease in the pediatric age group. As a group, the pediatric nephrologists are the oldest board-certified pediatric specialty in this country - 54% are over the age of 55 years. Many of the primary disease processes that account for the growing chronic kidney disease (CKD) "epidemic", estimated to affect 14% of the adult population (and known to be an important risk amplifier for cardiovascular events and mortality), actually begin in childhood, mandating greater involvement of pediatric nephrologists in research and clinical care pertaining to childhood antecedents of adult CKD and its complications. Children with chronic (prevalence unknown) and end-stage kidney disease (over 7,000 in the USA) also impose several unique medical challenges pertaining to growth, development, social and emotional needs as examples. To accomplish our training goals, each trainee will receive extensive experience in one of four research focus areas that have been selected on the basis of several criteria that include importance to the clinical practice of pediatric nephrology, established and/or emerging research expertise of the division faculty, and the availability of outstanding research faculty mentors outside the division at UW who are committed to training the fellows in our program. These research areas are: chronic kidney disease, acute kidney injury, immunology/infectious diseases and the kidney, and genetics and the kidney. Given the tremendous healthcare burden of CKD, this program continues its dedication to training a diverse group of young pediatricians as physician-scientists who can sustain and eventually lead the charge to prevent, treat and eliminate childhood-onset kidney diseases through novel research-driven discoveries. PUBLIC HEALTH RELEVANCE: The purpose of our training program is to provide young pediatricians with essential research skills and experiences to become physician-scientist specialists in the field of kidney disease. Not only is there a manpower shortage in this country, but the mean age of pediatric nephrologists is 56 years and many of those currently practicing are not actively engaged in research. Our long-term goal is to train the next generation of pediatric nephrologists who will be actively engaged in clinical, translational or basic science research that leads to new prevention strategies, diagnostic possibilities and treatment outcomes for the kidney diseases of childhood and beyond.